Provider Demographics
NPI:1891202305
Name:SOSA SANTANA, GEIDILEYDIS
Entity Type:Individual
Prefix:
First Name:GEIDILEYDIS
Middle Name:
Last Name:SOSA SANTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 NW 119TH ST UNIT 3316
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7910
Mailing Address - Country:US
Mailing Address - Phone:786-675-7408
Mailing Address - Fax:
Practice Address - Street 1:8851 NW 119TH ST UNIT 3316
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-7910
Practice Address - Country:US
Practice Address - Phone:786-675-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker